| NPI | 1831685627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 74625) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA11061900) |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2023-09-25 |